OBJECTIVETo explore the perioperative cardiovascular dysfunction and its relevance to age in patients with silent coronary heart disease (or silent myocardial ischemia), and explore the clinical treatment and recovery of perioperative arrhythmias.

METHODSOne hundred and eighty cases were selected from selective surgery patients with silent myocardial ischemia (SMI). Among the cases, 130 patients older than 51 years old were divided into 51 - 60 year-old group, 61- 70 year-old group and 71 - 80 year-old group. Control group was set up by other 50 patients younger than 51 years old. Electrocardiogram data of 24 h before the operation, 24 h after the operation and 48 h after the operation were continuously monitored by dynamic electrocardiogram (DCG). The electrocardiogram data of ST shifting, arrhythmia incidences of different type and at different time were analyzed by professional doctors. At the same time, the treatment and recovery of perioperative arrhythmia were recorded.

RESULTSAs the age increase, the magnitude and duration of ST shifting appeared upward trend compared to the control group (P < 0.05, P < 0.01). The incidence of ST elevation in 71 - 80 year-old group was higher than the control group (P < 0.05). The ST depression duration in 61 - 70 and 71 - 80 year-old group and ST elevation magnitude in 71 - 80 year-old group were higher than 51 - 60 year-old group (P < 0.05). Compared to the control group, the incidence of accelerated idioventricular rhythm (AIR) in 61 - 70 year-old group and the incidence of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). Compared to the 51 - 60 year-old group, the incidence of atrial fibrillation (AF) in 61 - 70 year-old group and the incidence of VP, VT, AF in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). The arrhythmia incidences in 24 h after operation were higher than 48 h after operation and 24 h before operation (P < 0.01). As the age increase, the recovery incidence by removing inducement was decreased, but the recovery incidences by drug and electric-shock treatment were increased (P < 0.05).

CONCLUSIONOld SMI patients have high levels of perioperative myocardial ischemia and arrhythmia, and 24 h after operation is the period of high incidence.

Aged ; Aged, 80 and over ; Cardiovascular System ; physiopathology ; Coronary Disease ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period

OBJECTIVETo explore material bases and neurobiological mechanisms of "Shen storing will" by observing learning and memory capacities and N-methyl-D-aspartic acid (NMDA) receptor expressions in Shen deficiency constitution (SDC) rats.

METHODSTotally 40 SD rats were randomly divided into the model group, the Zuogui Pill (ZP) group, the Yougui Pill (YP) group, the blank control group (consisting of normal pregnant rats), 10 in each group. SDC young rat model (inherent deficiency and postnatal malnutrition) was prepared by the classic way of "cat scaring rat". Medication started when they were scared by cat. Rats in the ZP group and the YP group were administered by gastrogavage with ZP suspension 0.1875 g/mL and YP suspension 0.0938 g/mL respectively. Equal volume of normal saline was administered to rats in the blank control group and the model group by gastrogavage. All medication was given once per day, 5 days in a week for 2 consecutive months. Learning and memory capacities were detected by Morris water maze test. Expressions of NMDA receptor subunits NR2A and NR2B in hippocamus were detected by immunohistochemical method.

RESULTSCompared with the blank control group, the latency period, total distance in Morris water maze test were longer in the model group (P < 0.05). All the aforesaid indices all decreased in the ZP group and the YP group, with statistical difference when compared with the model group (P < 0.05). The protein expressions of NR2A and NR2B in hippocamus were lower in the model group than in the blank control group (P < 0.05). But when compared with the model group, they were obviously higher in the ZP group and the YP group (P < 0.05).

CONCLUSIONSSDC rats had degenerated learning and memory capacities and lowered NMDA receptor expressions. ZP and YP could up-regulate learning and memory capacities and NMDA receptor expressions, thereby improving deterioration of brain functions in SDC rats.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Learning ; drug effects ; Memory ; drug effects ; Pregnancy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Up-Regulation

Reperfusion is the most effective treatment for acute myocardial infarction, markedly reducing mortality and morbidity. Reperfusion however induces necrotic and apoptotic damages to cardiomyocytes, that were viable prior to reperfusion, a process called myocardial ischemia/reperfusion injury(MI/RI). Over the past 30 years, hundreds of experimental interventions (both pharmacologic and nonpharmacologic) have been reported to protect the ischemic myocardium in experimental animals; however, with the exception of early reperfusion, none has been translated into clinical practice. The population-based survey assessed men have about twice the total incidence of morbidity and mortality of women, and the sex gap in morbidity tends to diminish after age 45 years. So hormone replacement therapy (HRT) is given to treat the MI/RI, and lots of studies shows that the side effect is greater for estrogen, compared with phyestrogen. In this article, we review the important pathogenesis of myocardial ischemia reperfusion injury, the prevention and limitations of HRT. And we highlight the mechanism of phyestrogens treatment the MI/RI in experiment. The aim is to provide the theoretically new way of develop the safe and effective products for the researchers.
Animals ; Humans ; Myocardial Ischemia ; drug therapy ; Myocardial Reperfusion Injury ; drug therapy ; Phytoestrogens ; administration & dosage ; Plant Extracts ; administration & dosage

One patient confirmed as pituitary carcinoma by histopathology was retrospectively analyzed according to the great changes of tumor invasive growth in imaging examine and clinical characters. Clinically,pituitary carcinoma quickly grows,and the growth character of tumor is helpful in the diagnosis. Moreover,the treatment for pituitary carcinoma is different from pituitary adenoma.The rapid progress of pituitary adenoma indicates the possibility of primary carcinoma.More experience should be accumulated for the diagnosis and treatment of the disease.

Objective To investigate symptom characteristics and their their prevalence in terminally ill patients with ovarian carcinoma.Methods A retrospective study was carried out based on clinical data of 98 terminally ill patients with ovarian carcinoma who died in our hospital during January 1995 to December 2004.Fifteen most common symptoms were analyzed with a focus on the followings:symptom incidence,survival time after symptom occurrence,regularity of symptom cluster,and common causes of death.Fifteen symptoms were:pain,cachexia,pleural effusion and ascites,dyspnea,fever,intestinal obstruction,renal failure,bone marrow depression,lung infection,hemorrhage,deep venous thrombosis (DVT),intestinal or pancreatic fistula,mycotic infection,jaundice and emergency conditions.Results (1)The most prevalent symptom was pleural effusion and ascites(63%),followed by pain(60%), cachexia(59%),dyspnea(52%)and intestinal obstruction(49 %).(2)The symptom which lasted longest survival time was mycotic infection(77 days),followed by intestinal or pancreatic fistula(75 days), intestinal obstruction(67 days),pain(60 days)and eachexia(60 days).Symptoms such as bone marrow depression,renal failure,dyspnea and emergency conditions were comparatively critical associated with shorter survival times(14,13,12,7 days,respectively).(3)Terminal symptoms occurred typically in clusters,with 4.9?1.5 symptoms per case.Of 98 cases,84 cases(86%)had 4 or more symptoms,with the median survival time of 63 days from the last day of anti-cancer therapy,and a slow death process.The remaining 14 cases(14%)with 3 or fewer symptoms survived only 25 days,of which 10 cases(71%)died of emergency diseases.The survival time for two groups was significantly different(P

OBJECTIVETo formulate the systems of prognostic evaluation that allowed urologists to easily calculate a T1G3 bladder cancer patient's short- and long-term risk score of recurrence, progression and death after transurethral resection.

METHODSThe 187 cases with T1G3 bladder cancer were diagnosed from January 1998 to October 2006. Clinical epidemiology study was carried out and prognosis information were collected. The expression of p53, fibroblast growth factor receptor 3 (FGFR3), E-cadherin, Ki-67 and microvesseldensity (MVD) of all patients' samples were detected using immunohistochemistry. The 18 prognostic risk factors were planed to estimate including gender, age, the time from symptom emerging to visiting doctor, hydronephrosis, operation ways, immediately intravesical instillation, drug of intravesical instillation, tumor size, number of tumors, tumor modality, cancer in situ, the first recurrence time ≤ 6 months, frequency of recurrence, p53, FGFR3, E-cadherin, Ki-67 and MVD. The risk factors were preliminary screened with Kaplan-Meier univariate analysis and then determined finally with multivariate Cox proportional hazards regression model. Based on the coefficients of the variables in the multivariate model, a weight for each level of each variable was obtained and the prognostic evaluation score of T1G3 bladder cancer was calculated.

RESULTSBased on an average follow-up of 46 months, 100 cases of T1G3 bladder cancer recurred (53.5%), 61 cases progressed (32.6%) and 37 cases died (19.8%). The 1-, 2-, 3-, 5-year probability of tumor recurrence was 35.0%, 60.0%, 63.0%, 65.0%. The 1-, 2-, 3-, 5-year probability of disease progression was 12.0%, 27.0%, 34.0%, 38.0% and the 1-, 2-, 3-, 5-year probability of death was 0, 11.0%, 17.0%, 26.0% respectively. The tumor size, number of tumors, immediately intravesical instillation, the first recurrence time ≤ 6 months, p53 and FGFR3 were the risk factors of the tumor recurrence of T1G3 bladder cancer. The total recurrence risk score of each patient was calculated. According the recurrence risk score, the patients were divided into -3-6 group, 7-19 group and 20-32 group. The 1-year probability of tumor recurrence was 3%, 35%, 81% in each group and the 5-year probability of tumor recurrence was 20%, 65%, 100%. The tumor modality, cancer in situ, the first recurrence time ≤ 6 months, frequency of recurrence, p53 and E-cadherin were the risk factors of the disease progression. The total progression risk score of each patient was calculated. According the progression risk score, the patients were divided into 6-14 group, 15-23 group and 24-30 group. The 1-year probability of progression was 2%, 19%, 56% in each group and the 2-year probability was 7%, 33%, 88%.Only progression was the risk factor of death (RR = 324.70, 95%CI:9.848-10707.800) .

CONCLUSIONSBased on the risk coefficient was translated into prognostic score and the tables of prognostic evaluation of T1G3 bladder cancer was founded initially, which showed the influence of each risk factor with intuitional scores. The model of prognostic evaluation of T1G3 bladder cancer could help the urologist to make decisions conveniently.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Urinary Bladder ; pathology ; Urinary Bladder Neoplasms ; pathology

Objective To investigate the imaging findings of the lacerating injury of the lung. Methods Ten patients of lung lacerating injury were examined by X-ray and CT within 1—5 h after injury. X-ray(2—5 times)and CT(3—5 times)examinations were repeated for 7 patients.Results The lung lacerating injury involved 10 sides and 14 lung lobes(21 lesions in total)in the 10 cases,among which 1 case involved the right upper lobe with 1 lesion,2 cases in the right lower lobe with 2 lesions,1 case in the right upper and lower lobes with 2 lesions for each lobe,3 cases in the left lower lobe with 9 lesions,and 3 cases in both the left upper and the lower lobes with 7 lesions.The X-ray findings were cavity-like shadows with smooth margin in 9 lesions(9/21),and patchy shadows of fogging margin in 12 lesions(12/21).The CT imaging findings included 6 pulmonary hematomas(6/21),and 15 cavitary lesions with air-fluid levels (15/21).In the 15 cavitary lesions,CT revealed 14 single cavities and 2 small cavities within a big cavity. On dynamic follow-up observation,the cavity was the biggest in 1—5 h after injury,but the hematoma was the biggest in 2—3 days after injury.Hematomas tended to absorb slower than the cavities.After 16— 32 days,all lesions revolved into small patchy or stripe-like shadows with slightly increased density. Conclusion Cavitary lesion with air-fluid level is the characteristic imaging finding of lung lacerating injury.CT surpasses X-ray plain film in revealing the details of lung lacerating injury.

OBJECTIVETo explore the effectiveness of intravenous immunoglobulin (IVIG) in treating patients with unexplained recurrent spontaneous abortion (URSA) and the effect of IVIG on the level of soluble human leucocyte antigen G (sHLA-G).

METHODSThis prospective trial conducted at PUMC Hospital between 2004 and 2008 included 60 women with URSA. The patients were allocated into IVIG group (30 cases) and control group (30 cases). IVIG was intravenously used before conception at a dose of 0.2g/kg; once pregnancy was confirmed,IVIG was continued every 4 weeks till the 20th gestational week. Traditional Chinese medicine or/and progesterone were used in control group. The outcome of pregnancy was evaluated by live birth rate and effective rate(defined as the embryo living 4 week longer than previous pregnancy). Serum samples were collected randomly before pregnancy and in the 6th-8th gestational week from IVIG group (15 samples),control group (15 samples),and healthy women (20 samples). The levels of sHLA-G,interferon γ (IFN-γ), interleukin-2 (IL-2), and interleukin-10 (IL-10) were determined by enzyme-linked immunosorbant assay (ELISA).

RESULTSThe pregnancy rate was 93.3% in IVIG group. The live birth rate and effective rate were 85.7% (24/28) and 92.9% (26/28) in IVIG group,which were significantly higher than those in control group [56.7% (17/30) (P=0.021) and 63.3% (19/30) (P=0.011)]. Emesis occurred in one woman (3.3%) in IVIG group had during IVIG infusion but was relieved by lowering the speed of infusion. The mean sHLA-G level was (61.37∓35.57) U/ml in control group and (62.70∓37.24) U/ml in IVIG group (P>0.05); both of them were significantly lower than that of healthy women (88.49∓25.37) U/ml (Pü0.05). After pregnancy was achieved, the levels of sHLA-G and IL-10 were (34.19∓14.21) U/ml and (11.71∓2.75) pg/ml, respectively in the IVIG group, which were significantly higher than those in control group [(23.71∓12.83) U/ml and (8.71∓3.01) pg/ml, respectively] (P=0.008).

CONCLUSIONSLow-dose IVIG before and after pregnancy is a safe and effective in treating URSA. IVIG improves the development of fetus by up-regulating sHLA-G and IL-10 levels.

Abortion, Habitual ; blood ; drug therapy ; immunology ; Adult ; Female ; HLA-G Antigens ; blood ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Pregnancy ; Prospective Studies ; Treatment Outcome

OBJECTIVETo observe the expressions of human beta-defensin 1 and 2 (hBD-1 and hBD-2) in nasal mucosa before and after the endoscopic sinus surgery and investigate the effects of hBD-1 and hBD-2 on the healing process after the surgery.

METHODSThe patients undergoing endoscopic sinus surgery for chronic sinusitis were divided into 3 groups according to the response to the surgery, namely cured group, response group and non-response group. With those from healthy control subjects as the control, nasal mucosa samples were collected from the patients at 1 week, 2 weeks, 1 month, 3 months and 6 months after the surgery for detection of hBD-1 and hBD-2 mRNA and protein expressions by RT-PCR and Western blotting.

RESULTShBD-1 and hBD-2 were expressed in both normal and chronic sinusitis mucosa, but the expression levels varied significantly between the individuals. The expression levels of hBD-2 was significantly correlated to the patients' response to the surgical treatment (P<0.05). hBD-1 showed slight differences between the individuals, but was not associated with the patients' prognosis.

CONCLUSIONThe expressions of hBD-2 mRNA and protein are significantly increased in patients with good response to endoscopic sinus surgery for chronic sinusitis, suggesting the value of hBD-2 as an indicator of the patients' prognosis.

Case-Control Studies ; Chronic Disease ; Endoscopy ; Humans ; Nasal Mucosa ; metabolism ; Postoperative Period ; Prognosis ; RNA, Messenger ; genetics ; Sinusitis ; metabolism ; surgery ; beta-Defensins ; metabolism

To investigate the resources of medicinal plant, such as wild Apocynum, supervised classification based on Principal Component Analysis (PCA) and texture feature were used to monitor wild medicinal plants from image captured by ZY-3 and World-view-2 and compare which satellite Image are more appropriate to monitor the wild medicinal plants. The research results shows that: for more complex growth conditions wild medicinal plants Apocynum, high-resolution images Worldview-2 is more suitable for its remote identification, the low-resolution satellite ZY-3 can only recognizes the wild medicinal plants which distributed intensively. If the study target distribution is more intensive and larger scale, and cultivated type medicinal plants, the use of satellite ZY-3 in low resolution remote sensing data to identify the target can be a good choice, it is not necessary to buy high-resolution data, in order to avoid waste of expenditure, for the scattered distribution, the high-resolution satellite imagery data may be indispensable to identify targets.
Apocynum ; chemistry ; growth & development ; China ; Conservation of Natural Resources ; Geographic Information Systems ; Plant Dispersal ; Plants, Medicinal ; chemistry ; growth & development ; Remote Sensing Technology ; methods